Sugammadex to rescue a ‘can't ventilate’ scenario in an anticipated difficult intubation: is it the answer?

Anaesthetic management of acute airway obstruction

“…(6,7) This is further supported by the introduction of sugammadex in 2008. (8) Thirdly, we discuss the recent use of videolaryngoscopes. Lastly, we discuss in greater detail the place of extracorporeal oxygenation in the management of AAO.…”

Sugammadex: An Update

“…The induction with rocuronium in patients with predicted difficult airway may be too risky and sugammadex rescue reversal is recommended to be retained for use in unanticipated difficult airways [29]. When facing a failed intubation -failed ventilation scenario following rocuronium induction, practitioners need to have an appropriate dose of sugammadex immediately available.…”

“…When facing a failed intubation -failed ventilation scenario following rocuronium induction, practitioners need to have an appropriate dose of sugammadex immediately available. A "wake-up" decision has to be taken within a few minutes [29,30].…”

Sugammadex in anticipated difficult airways5

“…The questions arising fall into two broad areas; firstly, critique of the anaesthetic plan related to this particular difficult airway; and secondly, comments regarding the broader issue of use of sugammadex for airway rescue. Both areas of scrutiny are entirely welcome and expected, given the lack of concordance of expert opinion on management of the predicted difficult airway [2] and the conflicting case report evidence regarding the success of sugammadex in airway rescue [3][4][5][6]. In addition, there is a lack of expert guidance on its use in this situation.…”